My first experience as a counselor was as a volunteer at a grief counseling agency that was associated with a hospice in Palo Alto, CA. That experience touched me so deeply that I left my career as a journalist and went back to school to get a degree in counseling psychology and a license as a therapist.
Throughout my career as a therapist I have continued to do grief counseling and to work with terminally ill people and their families. I consider it a gift to be able to do this work.
In this culture, grief is a taboo. We don’t talk about death and dying and we don’t talk about grief. So I’ve noticed over my years offering therapy and grief counseling that people find grief mystifying, confusing and often frightening.
A lot of my work as a grief counselor has been to help people demystify their experience, to help people recognize that grief is a normal response to loss, intense though it may be, and to find a way back to a balanced life.
To that end, I’ve put together this Q&A on grief for anyone who needs it. Feel free to pass it on. You can also download a copy here.
What is grief?
Grief is the reaction to loss. Grief applies to a variety of losses. But for the purposes of this discussion, grief is the reaction to the death of a loved one.
There are two types of grief:
- Acute grief: the immediate response to the death of a loved one.
- Bereavement: The ongoing progress of working through grief.
What are the feelings that accompany grief?
During grief people often experience, sadness, fear, anxiety, anger, guilt, helplessness, loss and confusion. There is very little new in grief, but the feelings tend to be more intense.
As a culture, we are generally unprepared for death. During the course of grief counseling, many people describe death and grief as frightening and disorienting. Some people are afraid that they might not survive the loss of someone close, or that the grief may never end. Some people experience anxiety that they may die next, or someone else may die soon.
While grieving, people may get angry at the fact of death. Some people feel angry at the person who died, which they find confusing. And some people feel guilty about being angry at someone who has died. In counseling, people have told me they feel angry at God for taking away a loved one.
People often experience guilt after a loss, especially when it involves a difficult relationship. There may be unresolved issues. People may feel guilty over things they did in the past, or things they didn't do or say when the deceased was alive. Grief counseling offers an opportunity to process the things left unsaid to someone who has died.
Bereavement can be exhausting. Some people feel like there is no pleasure left in life, or they'll never be happy again. Bereaved people sometimes feel helpless and confused. It’s often difficult to concentrate. People forget to take care of themselves out of a lack of concern for their own well being. They may forget to eat or neglect to exercise.
During grief people find themselves constantly thinking about the person who died. That is part of the process of coming to terms with the loss.
These are a few examples of the feelings that accompany grief. A more complete discussion can be found in the book: How to Go on Living When Someone You Love Has Died by Therese Rando.
What does a person need to do while grieving?
It is important after a death that people give themselves permission to grieve and feel the loss.
People often experience difficulty concentrating, or may feel unmotivated. It’s important to be realistic about what they can and cannot do. It’s a good time to lower expectations for work, social activities, work around the house. People may slow down on the job, or become disoriented in social situations.
Grieving people need to find a way to express their feelings about the loss. That can include talking, crying, writing, art work or exercise. During grief, bereaved people may need to process their relationship the deceased, with the view that the relationship has ended.
It is also important during grief that people take care of themselves - remember to eat and exercise, to take prescribed medications, etc. Some people need to be reminded to do so.
Is there a right way and a wrong way to grieve?
No. There is no one way to grieve. Each person finds his or her own way to grieve. As a grief counselor, many people have often told me they want to do the right thing by the person who has died – that they want to appropriately honor their loved one. There is no right or wrong way to grieve, and some people need to be reassured of that.
Some people may want to talk and/or cry all the time, and immerse themselves in grief. Other people may talk or cry very little. That doesn't mean they are not grieving. It’s just different for different people.
Is it important to go through grief?
Yes, it is very important to go through grief. Grief is the process of coming to terms with a loss. Grief can be painful and frightening. Some people may try not to feel grief or deny their feelings of loss. It takes more energy to deny a loss and hold off grief than it does to move through the grief process. Trying to avoid grief only prolongs it.
Do people get over grief?
Yes. People do get over grief if they are able to experience it. Grief takes time. At times it seems like the grief will never end. It is important to know that the acute grief - the pain of loss and separation - does diminish over time.
The loss itself remains. But you learn to live with it. It is an ongoing process. People do find happiness again, but they also find that their lives have changed.
How can we help people who are grieving?
Grief is a long-term process. People need help immediately after a loss, and later on after the relatives have gone home and friends have returned to their "normal lives."
Initially people may need assistance with the simple details of life - funeral arrangements, meals, transportation or child care.
To be the most helpful, offer specific suggestions. "Call me if you need anything" is not necessarily helpful to someone who may not know what they need, or is disoriented. Offer to help with the grocery shopping, baby-sitting the children, or help with any of the other regular tasks of life.
There's a popular misconception that after an "appropriate" time has passed, that it's inappropriate to talk about the deceased. The truth is that during grief people often need to talk about the death and recall memories of the deceased. They are often grateful for the opportunity to do so.
Grief doesn't come and go in six weeks. People need ongoing support. Birthdays and anniversaries are especially difficult times.
Grieving people need to be listened to. They don't need to be told what to do - to begin dating again, take a vacation, make new friends. These suggestions may seem helpful and logical to the people who are offering them. But they are often of little use, and sometimes a source of agitation, to someone in grief. I’ll have more on this in my next blog. The simple presence and concern of friends and loved ones are more comforting than suggestions that a grieving person get out more.
Where can people go for help?
I’m available for those who need grief counseling or help coping with death. I can be reached at email@example.com or (812) 371-6330. People can also find resources through hospital social workers, clergy and local hospice organizations, such as Hosparus Health in New Albany and Louisville.